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Create a Free AccountProcedures - Stent placement
Cognitive ERCP: decision making during successful retrieval of proximally migrated biliary stent
A 56-year-old man presented with painless jaundice. An outside CT scan reported a pancreatic head mass. The patient underwent ERCP with a 10F plastic biliary stent placement, and an EUS-guided biopsy confirmed the mass to be a pancreatic ductal adenocarcinoma. Subsequent staging CT chest/abdomen scans showed significant migration of the pre-existing plastic biliary stent, which was abutting the liver margin of the left hepatic lobe and the distal end was above the biliary stricture in the area of the hepatic hilum.EUS-guided gallbladder drainage and subsequent peroral endoscopic cholecystolithotomy: A tool to reduce chemotherapy discontinuation in neoplastic patients?
EUS-guided gallbladder drainage (EUS-GBD) is emerging as a valuable treatment for acute cholecystitis (AC) in patients unfit for surgery. When lumen-apposing metal stents are used, large-caliber access to the gallbladder allows for subsequent direct peroral endoscopic cholecystoscopy (POEC) and eventual cholecystolithotomy (CL), offering a potentially “curative” solution for frailer patients. The aim of this series was to evaluate the outcome of these procedures in oncologic patients experiencing AC, with a specific focus on chemotherapy continuity.Endoscopic radiofrequency ablation for palliative treatment of hilar cholangiocarcinoma
Recent data support a role for endoscopic radiofrequency ablation (RFA) in unresectable cholangiocarcinoma by improving stent patency and overall survival.Access fistulotomy: technical tips for success
Biliary cannulation, although critical to procedural success in ERCP, can be difficult and, if unsuccessful, can lead to longer hospital stays, repeat procedures, and increased costs. Expertise in adjunct techniques, including access fistulotomy, can increase success rates and potentially avoid these issues. The aim of this case series is to describe the technique of access fistulotomy and illustrate key points that are important for successful biliary access.Use of a novel single-use disposable duodenoscope for ERCP: selected clips from a real-world case series
Single-use/disposable duodenoscopes represent one strategy to decrease the risk of patient infection related to ERCP. A preliminary case series was performed to demonstrate the feasibility and performance of a new single-use duodenoscope in a real-world clinical setting.Safety of EUS-guided gallbladder drainage using a lumen-apposing metal stent in patients requiring anticoagulation
EUS-guided gallbladder drainage (EUS-GBD) can be used to treat acute cholecystitis in patients with medical comorbidities that prevent definitive operative management. Historically, nonsurgical management of cholecystitis was achieved by way of percutaneous gallbladder drainage.Placing a lumen-apposing metal stent despite ascites: feasibility and safety
Placing a lumen-apposing metal stent (LAMS) through ascites carries serious risks, including death from leakage around the LAMS and failure to create a mature fistula between the 2 lumens. However, sometimes no options exist or are equally dangerous. We present 5 patients who underwent LAMS placement despite ascites in 2 different locations.Extrabiliary applications of fully covered antimigration biliary metal stents
Endoscopic stent placement in luminal GI strictures is not always feasible with traditional stents. For example, standard luminal stent delivery catheters may not successfully traverse severe strictures, and enteral stents may not be suitable for sites in the GI tract that pose significant adverse events if downstream migration were to occur. We demonstrate extrabiliary applications of specialized, fully covered antimigration biliary metal stents.EUS-guided transrectal drainage of pelvic fluid collections using electrocautery-enhanced lumen-apposing metal stents: a case series
Pelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. A percutaneous approach to deep PFCs could be challenging and result in a longer, painful recovery. The transvaginal approach has been considered easy but is limited by the difficulty of leaving a stent in place. The transrectal approach has been described, but issues related to fecal contamination were hypothesized. Data on EUS-guided transrectal drainage (EUS-TRD) with lumen-apposing metal stents (LAMSs) are few and suggest unsatisfactory outcomes.EUS-guided stent removal in buried lumen-apposing metal stent syndrome: a case series
Lumen-apposing metal stents (LAMSs) play an increasing role in transgastric and transduodenal drainage of pancreatic fluid collections and allow novel EUS-guided interventions. Alongside the main adverse events of bleeding and occlusion, LAMSs can be overgrown by mucosa, which leads to the inability to visualize the stent in endoscopy.
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